Patient Readiness to Use Internet Health Resources

描述(由申请人提供)：对于美国超过1亿的慢性病患者来说，与他们的医疗团队合作是有效、高质量医疗的一部分。正如慢性护理模式所建议的那样，互联网卫生资源和交流可以成为改善护理的一个重要因素。该模型的重点可能是支持提供者文档和交流的信息技术，以及基于网络的患者自我管理、教育和健康交流；这种技术可以使患者激活和自我管理。在全国范围内，50%的慢性病患者使用互联网。然而，关于是什么促进或阻碍了互联网卫生资源的使用，或者它对消费者的影响，几乎没有信息可用。为此，我们建议研究这些启动子和障碍，以及使用这些启动子和疾病结果的关联。我们将开发一种实用的衡量慢性病患者是否准备好使用基于网络的卫生资源的指标，并根据这些患者实际使用这些资源的日志测试该指标的预测有效性，并直接观察他们对这些资源的使用情况(目标1)。我们将研究基于网络的资源的使用如何与糖尿病患者的临床结果相关(目标2)。这种对慢性病门诊患者使用基于网络的卫生资源偏好的丰富检查将为寻求将在线环境作为综合疾病管理战略的一部分的项目、系统和政策提供信息。尽管库普曼博士在慢性病研究领域经验丰富，但这一主题的深远重要性以及对该领域新技能的需求促使她获得了职业发展奖，将其作为未来翻译研究的重要一步。库普曼博士将利用她与她的导师大卫·迈尔博士建立的关系，以及他目前获得资助的AHRQ工作《使用医疗信息技术改善动态慢性病护理》(1R18HS017035-01)，该工作旨在评估一个新的基于网络的互动患者健康门户网站的有效性。除了拟议的研究外，这项申请的结构化职业发展计划还包括仪器开发和人机交互方面的补充培训，以及多学科咨询委员会的科学和职业指导，以及负责任的研究行为方面的持续培训。如果获奖，库普曼博士所在的部门和机构承诺，她75%的时间将致力于这些研究和职业发展活动。这一职业发展奖将使库普曼博士在规模开发和人机交互方面获得专业知识。这些专业知识将为拟议的研究提供信息，以确定慢性病患者使用互联网卫生资源的促进者和障碍。她还将调查互联网卫生资源的使用与疾病结局的关系。这些知识将为寻求使用在线环境来改善对患者的护理的项目、系统和政策提供信息。

DESCRIPTION (provided by applicant): For the more than 100 million patients with chronic conditions in the United States, collaborating with their health care team is part of effective, high-quality care. Internet health resources and communication can be an important element in improving care, as suggested by the Chronic Care Model. The model's keystone may be information technology that supports provider documentation and communication, as well as web-based patient self-management, education, and health communication; such technology can enable patient activation and self-management. Nationally, 50 percent of patients with chronic disease use the internet. However, little information is available on what promotes or is a barrier to use of internet health resources, or its effect on the consumer. To that end, we propose to examine these promoters and barriers, as well as the association of use with disease outcomes. We will develop a practical measure of the readiness of ambulatory patients with chronic conditions to use web-based health resources, test the predictive validity of the measure against logs of actual use of these resources by these same patients, and directly observe their use of these resources (Aim 1). We will examine how use of web-based resources is associated with clinical outcomes for patients with diabetes (Aim 2). This rich examination of preferences for use of web-based health resources among ambulatory patients with chronic disease will inform projects, systems, and policies that seek to use the online environment as part of a comprehensive disease management strategy. Although Dr. Koopman is experienced in the area of chronic disease research, the profound importance of this topic and the need for new skills in this area led her to the proposed Career Development Award as an important step toward future translational research. Dr. Koopman will leverage her established relationship with her mentor, Dr. David Mehr, and his currently funded AHRQ work "Using Health IT to Improve Ambulatory Chronic Disease Care" (1R18HS017035-01), which aims to evaluate the effectiveness of a new web-based interactive patient health portal. In addition to the proposed research, this application's structured career development plan includes supplementary training in instrument development and human- computer interaction, as well as scientific and career guidance from a multidisciplinary advisory committee and continued training in the responsible conduct of research. If awarded, Dr. Koopman's department and institution pledge that 75% of her time will be devoted to these research and career development activities. This Career Development Award will allow Dr. Koopman to gain expertise in scale development and in human computer interaction. This expertise will inform the research proposed, to identify promoters and barriers to the use of internet health resources by ambulatory patients with chronic conditions. She will also investigate how use of internet health resources is associated with disease outcomes. This knowledge will inform projects, systems, and policies seeking to use the online environment to improve care for patients.